Understanding
Cervical Changes
A Health Guide
U.S. Department of Health & Human Services | National Institutes of Health
b
“This booklet helped me
talk with my doctor
after an abnormal
test result.”
“My doctor explained that cervical
cancer screening tests can nd
changes in cervical cells that are
not cancer and can be treated.
This was reassuring to know.”
“Now that my child is 11,
my daughter’s doctor said
she is due for vaccinations
to help protect her from
meningitis, whooping cough,
and HPV-related cancers.”
Health care providers: Here’s a handout that can help your patients access an online version of
this booklet: www.cancer.gov/ucc-flyer.
i
Table of Contents
Use this guide to learn more and talk with
your health care provider about:
Introduction ii
HPV Infection 1
Cervical Cancer Screening 2
Screening Guidelines: When to Get Screened 4
HPV Test Results 6
Pap Test Results 7
Follow-up Tests and Procedures 9
Treatments for High-Grade Cervical Cell Changes 12
HPV Vaccination 14
Related Resources 15
i
ii
Introduction
You may be reading this booklet because you had an abnormal cervical cancer
screening test. Although it’s common to feel uneasy, you should know that most
women who have abnormal cervical screening test results do not have cervical cancer.
Most have early cell changes that can be monitored (since they often go away on their
own) or treated early (to prevent problems later). So, get the follow-up visits, tests, or
treatment that your health care provider advises.
Scientific advances have helped us learn much more about how cervical cancer
develops, as well as how and when to screen women. However, these advances have
also added a layer of complexity for health care providers and women. This booklet
helps you talk with your health care provider and make informed decisions to prevent
cervical cancer.
Goodnewsabout
preventing cervical cancer
We know what causes cervical cancer.
Nearly all cervical cancer is caused by a virus called HPV (human papillomavirus).
Cervical cell changes happen slowly.
It can take many years for cells infected with HPV to develop into cervical cancer.
We have great tools to prevent cervical cancer.
Cervical cancer screening and HPV vaccination can prevent cervical cancer.
Better screening tests mean less frequent screening.
Because of improvements in cervical cancer screening, guidelines now recommend less
frequent screening than before.
Abnormal test results don’t mean that you have cancer.
An abnormal cervical screening test result does not mean that you have cervical cancer.
It means that cervical cell changes were found or that cells are infected with HPV.
Depending on the results, you may need follow-up testing or treatment. Treatment for
cervical cell changes works well.
1
HPV Infection
“My doctor told me that long-lasting
infections with certain HPV types can
cause cancer in the cervix, vagina,
and vulva, as well as in the anus,
penis, and parts of the mouth.”
Human papillomavirus (HPV) and cervical cell changes
HPVs are a group of related viruses, some of which are spread through sexual contact and can
cause cancer, including cervical cancer. Here are some basic facts about HPV:
There are many types of sexually transmitted human papillomaviruses (HPVs).
●
High-risk HPV types can infect cervical cells and cause cervical cancer. They can also
infect certain other cells to cause anal cancer, penile cancer, vaginal cancer, vulvar cancer,
and oropharyngeal cancer (cancer in the middle of the throat, including the tonsils and the
back of the tongue).
●
Low-risk HPV types can cause genital warts. These are warts on the external and internal
sex organs and glands. Genital warts do not turn into cancer.
Smoking may increase the risk that an HPV infection will persist and develop into cervical
cancer. So if you smoke and have an abnormal Pap or HPV test result, it is especially
important to stop smoking.
HPV infections are common. Most people who are sexually active will have an HPV
infection at some point and never know it. HPV infections can be spread through skin-to-skin
contact, including vaginal, anal, and oral sex. Although condoms can lower the risk of an
HPV infection, they do not protect against them completely.
Most HPV infections, even with high-risk types, go away on their own without
causing problems. They are fought off by the body’s immune system. However, sometimes
infections with high-risk HPV types do not go away. When a high-risk HPV infection of
cervical cells lasts many years, the cells can become abnormal. These changes can get worse
over time and may become cervical cancer. Although there is currently no way to treat an
HPV infection, cervical cancer can be prevented by detecting and removing abnormal cervical
cells before they become cancer.
For more information about HPV and cancer, visit: www.cancer.gov/hpv.
2
Cervical Cancer Screening
“Cervical cancer screening can nd
abnormal cell changes that can be
monitored or treated early, before
they develop into cervical cancer.”
Screening tests for cervical cancer
Screening tests are used to check for disease when there are no symptoms. The goal of
screening for cervical cancer is to find cell changes at an early stage before they become
cancer and when treatment can prevent cancer from developing.
The HPV test checks cells for infection with high-risk HPV types that can cause cancer.
The Pap test (also called a Pap smear or cervical cytology) collects cervical cells and looks at
them for changes caused by HPV that may—if left untreated—turn into cervical cancer. It can
also detect cervical cancer cells. A Pap test sometimes finds conditions that are not cancer,
such as infection or inflammation.
The HPV/Pap cotest uses a Pap test and HPV test together to check for both high-risk HPV
and cervical cell changes.
Where to get screened
Doctors’ offices, clinics, and community health centers offer HPV and Pap tests. Many women
receive these tests from their ob/gyn (obstetrics/gynecology) or primary care provider. If you
don’t have a primary care provider, or doctor you see regularly, you can find a clinic near you
that offers cervical cancer screening by contacting:
●
Your state or local health department.
●
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) by calling
1-800-232-4636 or visiting www.cdc.gov. NBCCEDP is a service of the CDC that provides
low-income, uninsured, and underserved women access to cervical cancer screening and
diagnostic services.
●
A Planned Parenthood clinic by calling 1-800-230-7526 or visiting:
www.plannedparenthood.org.
●
NCI’s Cancer Information Service (CIS) by calling 1-800-422-6237 or visiting:
www.cancer.gov/contact.
3
What to expect
Cervical cancer screening is usually done during
a pelvic exam, which takes only a few minutes.
During this exam, you lie on your back on an
exam table, bend your knees, and put your feet
into supports at the end of the table. The health
care provider uses a speculum to gently open your
vagina in order to see the cervix. A soft, narrow
brush or tiny spatula is used to collect a small
sample of cells from your cervix.
The sample of cervical cells is sent to the lab and
checked for abnormal cervical cells. The same
sample can also be checked for HPV, with an HPV
test. When both a Pap test and an HPV test are
done, this is called HPV/Pap cotest.
A pelvic exam may include more than taking
samples for an HPV and/or Pap test. Your health
care provider may also check the size, shape, and
position of the uterus and ovaries and feel for any
lumps or cysts. The rectum may also be checked
for lumps or abnormal areas. Most health care
providers will tell you what to expect at each step
of the exam, so you will be at ease. You may also
ask to be tested for other sexually transmitted
infections (STIs).
Questions to ask
Before your exam
Ask your health care provider:
●
What will happen during the exam?
●
What tests will I have?
●
What is the purpose of these tests?
●
Will I have any discomfort?
Your health care provider
may ask you:
●
What was the start date of your
last menstrual period?
●
When did you have your last
cervical cancer screening test?
●
What were your test results?
●
Have you ever had abnormal
test results?
●
Have you ever had treatment for
abnormal cells on your cervix?
After your exam
Ask your health care provider:
●
When will I get my test results?
●
How will I get these results
(e.g., by mail, online, or phone call)?
●
What phone number should I call
if I do not get my test results?
●
When I get my results, will they
explain what I should do next?
The female
reproductive system
The cervix is part of the female
reproductive system. It’s the
lower, narrow end of the uterus,
which leads to the vagina. The
cervix opens during childbirth
to allow the baby to pass
through.
4
Screening Guidelines:
When to Get Screened
“Talk with your family and friends
about screening for cervical cancer.
Over 4,000 women in the United
States die of cervical cancer every
year. Cervical cancer is easy to
prevent with routine screening.”
Cervical cancer screening recommendations have been developed by organizations,
including the United States Preventive Services Task Force (USPSTF) and the American
Cancer Society. While the details of the recommendations vary, they are based on research
findings such as:
●
HPV-caused changes in cervical cells happen slowly and often go away on their own,
especially in younger women
●
more effective screening tests
●
the harms of overtesting and overtreatment for cervical cell changes that would have gone
away on their own
Cervical cancer screening guidelines for most women
Talk with your health care provider about when to start screening, how often to be
screened, and what screening test to have. These ages and times between screenings apply
to most women, as long as they have normal test results. Exceptions to these screening
recommendations are noted in the box on
page 5.
“Get a free or low-cost cervical cancer
screening test. It’s available if you don’t have
health insurance or have a low income. Go to
www.cdc.gov/cancer/nbccedp to learn more
and nd a screening program near you.”
5
Age 21-29 years
Get your first Pap test at age 21 and
have Pap testing every 3 years. Even
if you are already sexually active,
Pap tests are not recommended
until age 21, according to USPSTF
recommendations.
Age 30-65 years
Get an HPV test every 5 years, an
HPV/Pap cotest every 5 years, or a
Pap test every 3 years, according to
USPSTF recommendations.
The American Cancer Society
recommends HPV tests every 5 years,
starting at age 25. Screening with an
HPV/Pap cotest every 5 years or a Pap
test every 3 years is also acceptable.
Older than 65 years
If you are in this age group you
should talk with your health care
provider to learn if screening is still
needed. If you have been screened
regularly and had normal test results,
your health care provider will probably
advise that you no longer need
screening. However, if your recent
test results were abnormal or you
have not been screened regularly,
you need to continue screening
beyond age 65.
For more information about screening
guidelines, visit: www.cancer.gov/ucc.
Exceptions to
the guidelines
Talk with your health care provider about whether
you need a personalized screening plan.
Certain health conditions
More frequent screening may be recommended
if you:
●
are HIV positive
●
have a weakened immune system
●
were exposed before birth to a medicine
called diethylstilbestrol (DES), which was
prescribed to some pregnant women
through the mid-1970s
●
had a recent abnormal cervical screening
test or biopsy result
●
have had cervical cancer
Hysterectomy
Screening recommendations are based on your
personal medical history, including the type of
hysterectomy you may have had:
●
Partial hysterectomy or supracervical
hysterectomy: If you had an operation to
remove your uterus but not your cervix,
you should continue routine cervical
cancer screening.
●
Total hysterectomy: If you had an operation
to remove both your uterus and cervix for
reasons not related to cancer or abnormal
cervical cells, you do not need to be
screened for cervical cancer.
●
Hysterectomy: If you had any type of
hysterectomy related to cervical cancer
or precancer, talk with your health care
provider to learn what follow-up care
you need, based on your specific
medical history.
6
HPV Test Results
HPV test results show if high-risk HPV types were found in cervical cells. An HPV test will
come back as a positive test result or a negative test result:
●
Positive HPV test result: High-risk HPV was found. Your health care provider will
recommend follow-up steps you need to take based on your specific test result, such as
those listed in the Follow-up Tests and Procedures section on
page 9.
●
Negative HPV test result: High-risk HPV was not found. You need to be tested again in
5 years. However, your health care provider may advise you to come back sooner if you had
abnormal results in the past.
HPV test results usually come back from the lab in about 1–3 weeks. If you don’t hear from
your health care provider, call and ask for your test results. Make sure you get any follow-up
tests or procedures that are recommended.
What does it mean if I have a positive HPV test after years
of negative tests?
Sometimes, after several negative HPV tests, you may have a positive HPV test result. If you
have a new sexual partner, this is most likely a new infection. If you do not have a sexual
partner, or if you are in a monogamous relationship, this is not necessarily a sign of a new
HPV infection, and it doesn’t mean that your partner has a new sexual partner. Sometimes
an HPV infection can become active again after many years. Some other viruses behave this
way as well; for example, the virus that causes chickenpox can reactivate later in life to cause
shingles.
There is no way to tell whether a newly positive HPV test result is a sign of a new infection
or a reactivation of an old infection. Researchers don’t know whether a reactivated HPV
infection has the same risk of causing cervical cell changes or cervical cancer as a new HPV
infection.
“I help my patients understand what
their HPV test result means, and
what monitoring or follow-up care
is needed.”
7
Pap Test Results
Pap test results show if cervical cells are normal or abnormal. A Pap test may also come back
as unsatisfactory.
●
Normal Pap test result: A normal Pap test result may also be called a negative test
result or negative for intraepithelial lesion or malignancy (NILM). If only the Pap test
was done, you should have another Pap test in 3 years. If the Pap test was done together
with an HPV test (this is called a Pap/HPV cotest), you should have this test again in 5
years. You may need to come back sooner if you have had abnormal results in the past..
●
Abnormal Pap test result: An abnormal test result may also be called a positive test
result. An abnormal Pap test result does not mean you have cervical cancer. Possible
abnormal findings on a Pap test include ASC-US, AGC, LSIL, ASC-H, HSIL, AIS, or
cervical cancer. Your health care provider will recommend follow-up steps you need to
take based on your specific test result and your past test results.
●
Unsatisfactory Pap test result: The lab sample may not have had enough cells, or the
cells may have been clumped together or hidden by blood or mucus. Your health care
provider will usually ask you to come in for another screening test in 2 to 4 months.
Pap test results usually come back from the lab in about 1–3 weeks. If you don’t hear from
your health care provider, call and ask for your test results. Make sure you receive your test
results and understand any follow-up visits or treatments that you need.
Cervical cell changes
These images show how cervical cells that have long-lasting infections with high-risk HPV
can change over time and become abnormal. Abnormal cervical cells may also return to
normal even without treatment, especially in younger women. LSIL and HSIL are two types
of abnormal changes to cervical squamous cells.
8
Pap test results and possible next steps
ASC-US
Atypical
Squamous Cells
of Undetermined
Significance
Atypical Squamous Cells of Undetermined Significance (ASC-US) is the most
common abnormal Pap test finding. It means some cells don’t look completely
normal, but it’s not clear if the changes are caused by HPV infection. Other things
can cause cells to look abnormal, including irritation, some infections (such
as a yeast infection), growths (such as polyps in the uterus), and changes in
hormones that occur during pregnancy or menopause. Although these things
may make cervical cells look abnormal, they are not related to cancer. Your health
care provider will usually do an HPV test to see if the changes may be caused by an
HPV infection. If the HPV test is negative, estrogen cream may be prescribed to
see if the cell changes are caused by low hormone levels. If the HPV test is positive,
you may need additional follow-up tests as explained on page 9.
AGC
Atypical Glandular
Cells
Atypical Glandular Cells (AGC) means some glandular cells were found that do
not look normal. This can be a sign of a more serious problem up inside the uterus,
so your health care provider will likely ask you to come back for a colposcopy, as
explained on page 10.
LSIL
Low-Grade
Squamous
Intraepithelial
Lesions
Low-Grade Squamous Intraepithelial Lesions (LSIL) means there are low-grade
changes that are usually caused by an HPV infection. Your health care provider will
likely ask you to come back for more testing, as explained on page 10, to make
sure that there are not more serious (high-grade) changes.
ASC-H
Atypical Squamous
Cells, Cannot
Exclude HSIL
Atypical Squamous Cells, cannot exclude HSIL (ASC-H) means some abnormal
squamous cells were found that may be a high-grade squamous intraepithelial lesion
(HSIL), although it’s not certain. Your health care provider will likely ask you to
come back for a colposcopy, as explained on page 10.
HSIL
High-Grade
Squamous
Intraepithelial
Lesions
High-Grade Squamous Intraepithelial Lesions (HSIL) means there are moderately
or severely abnormal cervical cells that could become cancer in the future if not
treated. Some lesions may be called precancer. Your health care provider will likely
ask you to come back for a colposcopy, as explained on page 10.
AIS
Adenocarcinoma
In Situ
Adenocarcinoma in situ (AIS) means an advanced lesion (area of abnormal tissue)
was found in the glandular tissue of the cervix. AIS lesions may become cancer
(cervical adenocarcinoma) if not treated. Your health care provider will likely ask
you to come back for a colposcopy and biopsy, as explained on page 10.
Cervical
Cancer
Cells
Cervical cancer cells (cervical squamous cell carcinoma or cervical
adenocarcinoma) are sometimes found on a Pap test. However, this finding is very
rare for women who have been screened at regular intervals.
For more information about cervical cancer and treatment, visit:
www.cancer.gov/types/cervical.
9
Follow-up Tests and Procedures
Keep in mind that most women with abnormal cervical screening test results do not have
cancer. However, if you have an abnormal test result, it’s important to get the follow-up care
that is recommended. Next steps are based on your chances of developing severe cervical cell
changes that could become cervical cancer, if not treated.
“Most women who have an abnormal
test result do not have cervical
cancer. However, follow-up testing
and treatment may be needed.”
Follow-up care
In addition to your current test result, your health care provider will consider factors such as
these when recommending follow-up care:
●
previous screening test results,
●
any previous treatments for precancerous cervical cell changes, and
●
personal health factors, such as your age.
You may be advised to:
●
return for a repeat HPV test or HPV/Pap cotest in 1 or 3 years,
●
have a colposcopy and biopsy, or
●
receive treatment, as explained on page 12.
The goal is to detect and treat severe cervical cell changes that could develop into cervical
cancer while also decreasing testing and treatment for less severe conditions (low-grade
cervical cell changes).
For more information about risk-based screening guidelines, visit: www.cancer.gov/ucc.
10
What to expect during a colposcopy
A colposcopy is a procedure that allows the cervix to be examined. During this procedure,
your health care provider inserts a speculum to gently open the vagina and view the cervix.
A vinegar solution will be applied to the cervix to help show abnormal areas. Your health care
provider then places an instrument called a colposcope close to the vagina. It has a bright
light and a magnifying lens and allows your health care provider to look closely at your
cervix.
During a colposcopy, a cervical biopsy is usually done. This is a procedure in which a sample
of abnormal tissue is removed from the cervix so that the cervical cells can be studied under a
microscope.
Talk with your health care provider to learn what to expect during and after your biopsy
procedure. Some women have bleeding and/or discharge after a biopsy. Others have pain
that feels like cramps during menstruation. Biopsy samples are checked by a pathologist for
cervical intraepithelial neoplasia (CIN).
Biopsy findings: Cervical intraepithelial neoplasia (CIN)
CIN is the term used to describe abnormal cervical cells that were found on the surface of the
cervix after a biopsy.
CIN is graded on a scale of 1 to 3, based on how abnormal the cells look under a microscope
and how much of the cervical tissue is affected. LSIL (also called low-grade squamous
intraepithelial lesion, or mild dysplasia) seen on a Pap test is generally CIN 1. HSIL (also
called high-grade squamous intraepithelial lesion, or moderate or severe dysplasia) seen on a
Pap test can be CIN 2, CIN2/3, or CIN 3.
●
CIN 1 changes are mild, or low grade. They usually go away on their own and do not
require treatment.
●
CIN 2 changes are moderate and are typically treated by removing the abnormal cells.
However, CIN 2 can sometimes go away on its own. Some women, after consulting with
their health care provider, may decide to have a colposcopy with a biopsy every 6 months.
CIN 2 must be treated if it progresses to CIN 3 or does not go away in 1 to 2 years.
●
CIN 3 changes are severely abnormal. Although CIN 3 is not cancer, it may become cancer
and spread to nearby normal tissue if not treated. Unless you are pregnant, it should be
treated right away.
11
Pregnancy and treatment of high-grade cervical cell changes
If you are pregnant or plan to become pregnant and are found to have high-grade cervical cell
changes, your health care provider will talk with you about treatments that are recommended
for you and the timing of these procedures. Depending on your specific diagnosis, you may
be treated postpartum, or after delivery.
Questions to ask before a test or procedure
●
What is the purpose of this test or procedure? _____________________________
____________________________________________________________________
●
What will the results tell us? _____________________________________________
____________________________________________________________________
●
What will happen during the procedure? __________________________________
____________________________________________________________________
●
How long will the procedure take? ________________________________________
●
Should I limit any activities after the procedure? For how long? ________________
____________________________________________________________________
●
What problems or side eects should I call you about after the procedure? ______
____________________________________________________________________
“My doctor answered all my
questions and explained what
to expect during and after the
procedure. That put me at ease.”
12
Treatments for High-Grade
Cervical Cell Changes
These treatments are used when a woman has high-grade cervical cell changes that have a
high risk of developing into cancer. Your health care provider will talk with you about which
treatment is recommended for you and why. The questions on the next page can help you
talk with your health care provider to learn more.
“It was reassuring to talk with my doctor.
She helped me understand what to expect.
It was comforting to learn how this
treatment would help me.”
Common treatment procedures
Treatments that remove abnormal cells are called excisional treatments:
●
Cold knife conization (also called cold knife cone biopsy): A scalpel or laser knife is used
to remove a cone-shaped section of abnormal tissue. This procedure is done at the hospital
and requires general anesthesia.
●
LEEP (loop electrosurgical excision procedure): A thin wire loop, through which an
electrical current is passed, is used to remove abnormal tissue. Local anesthesia is used to
numb the area. This procedure is done in your health care provider’s office. It takes only a
few minutes, and you will be awake during the procedure.
Treatments that destroy abnormal cells are called ablative treatments:
●
Cryotherapy: A special cold probe is used to destroy abnormal tissue by freezing it. This
procedure is done in your health care provider’s office. It takes only a few minutes and
usually does not require anesthesia.
●
Laser therapy: A laser (narrow beam of intense light) is used to destroy abnormal tissue.
This procedure is done at the hospital and general anesthesia is used.
13
Questions to ask before treatment
●
What are the possible treatments for the condition that I have? _______________
____________________________________________________________________
____________________________________________________________________
●
Which treatment do you recommend for me, and why? ______________________
____________________________________________________________________
____________________________________________________________________
●
What are the advantages and disadvantages of this treatment? ________________
____________________________________________________________________
____________________________________________________________________
●
What will happen during the treatment? ___________________________________
____________________________________________________________________
____________________________________________________________________
●
What are the possible risks of this treatment? ______________________________
____________________________________________________________________
____________________________________________________________________
●
How might this treatment aect a future pregnancy? ________________________
____________________________________________________________________
____________________________________________________________________
●
How long will the procedure take? _______________________________________
____________________________________________________________________
____________________________________________________________________
●
Will general or local anesthesia be needed? ________________________________
____________________________________________________________________
____________________________________________________________________
●
What side eects might I have from this procedure? ________________________
____________________________________________________________________
____________________________________________________________________
●
How long might these side eects last? ___________________________________
____________________________________________________________________
____________________________________________________________________
●
Are there any activities that I should avoid after the procedure? _______________
____________________________________________________________________
____________________________________________________________________
14
HPV Vaccination
Human papillomavirus (HPV) vaccination protects against infection with HPV types that cause:
●
nearly all cases of cervical cancer
●
most cases of anal cancer and many cases of penile cancer, vaginal cancer, vulvar
cancer, and oropharyngeal cancer (cancer in the middle of the throat, including the
tonsils and the back of the tongue).
HPV vaccination also protects against infection by the HPV types that cause most warts on or
around the genitals and anus.
“Call your child’s doctor or your
local health clinic to have your son
or daughter receive the HPV vaccine.
This vaccine protects against certain
types of cancer.”
Answersto
commonlyaskedquestions
At what age should children get the HPV vaccine?
Girls and boys should start the HPV vaccine series at age 11 or 12; it may be started at
age 9.
How many doses are given?
●
Under age 15: Two doses of the vaccine are given. The second dose is given 6–12
months after the first dose. This provides as good or better protection than three
doses given at older ages. Preteens have a stronger immune response to the HPV
vaccine than older adolescents and can get fewer doses.
●
Ages 15-26: Three doses of the vaccine are given. The second dose is given 1–2
months after the first dose, and the third dose is given 6 months after the first dose.
What if someone didn’t complete the series?
HPV vaccination is recommended for children and adults, up to age 26 if necessary, to
complete the series.
15
Can the HPV vaccine be given at older ages?
Yes, the vaccine can be given to adults between the ages of 27 and 45 who didn’t
receive all vaccine doses earlier. Adults in this age group benefit less from the vaccine
because they are more likely to have been exposed to HPV already. Therefore,
vaccination is not routinely recommended for people in this age group. If you are
concerned that you are at risk for a new HPV infection, talk with your health care
provider about whether HPV vaccination may be right for you.
Do vaccinated women still need to be screened for cervical cancer?
Yes. Because HPV vaccination doesn’t protect against all HPV types that can cause
cervical cancer, it’s important to get screened for cervical cancer.
Is the HPV vaccine safe?
Yes. Side eects of the HPV vaccine are similar to those of other vaccines and may
include mild pain in the arm where the vaccine was given. Sometimes a slight fever,
dizziness, or nausea may occur.
What impact has HPV vaccination had so far?
Research has found that HPV vaccination is highly eective in preventing cervical
cancer, high-grade cervical lesions, and genital warts.
Related Resources
National Cancer Institute
The National Cancer Institute has information to help you learn more about cervical cancer
prevention, screening, and treatment:
●
Visit our cervical cancer home page: www.cancer.gov/types/cervical
●
Contact a cancer information specialist: www.cancer.gov/contact or call 1-800-422-6237
(1-800-4-CANCER)
●
Access other formats (PDF, e-book, and Kindle) of this guide: www.cancer.gov/ucc-guide
●
View this online resource: Next Steps after an Abnormal Cervical Cancer Screening
Test: Understanding HPV and Pap Test Results at www.cancer.gov/ucc
Centers for Disease Control and Prevention (CDC)
The CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) helps
low-income, uninsured, and underinsured women gain access to timely breast and cervical
cancer screening, diagnostic, and treatment services. NBCCEDP also provides patient navigation
services to help women overcome barriers and get timely access to quality care. Call 1-800-
232-4636 (1-800-CDC-INFO) or visit www.cdc.gov/cancer/nbccedp to learn more.
Scan this QR code to access all
available formats of this publication
Check out other publications
from the National Cancer Institute (NCI)
Oce of Communications and Public Liaison
www.cancer.gov/publications/patient-education
NIH Publication No. 21-5199
September 2021
